Abstract 664: Cerebrovascular Events in Patients Undergoing Endovascular Aortic Repair (EVAR) versus Open Aortic Repair (OAR) for Abdominal Aortic Aneurysm (AAA): A Pooled Meta-Analysis of 10,409 Patients

Abstract

Background: EVAR is still a relatively new modality for AAA repair and there are not many studies on the complications and risks associated with this procedure. In particular, there is a paucity of data in regards to the risks of Cerebrovascular Events (CVE). The purpose of the paper is to discuss the risks of CVE in patients who have undergone EVAR versus patients that have undergone OAR. We aimed to do a systematic review and meta-analysis of the CVE rates in patients undergoing EVAR versus OAR. Methods: Studies were included if they reported CVE outcomes comparing EVAR versus OAR in patients who underwent AAA repair. Of the 51 unique citations identi[[Unable to Display Character: fi]]ed after the initial literature search and supplementary hand-searches, 10 studies comparing EVAR and OAR who underwent AAA repair met our inclusion criteria. Results were independently extracted by 2 reviewers. A random effects model was applied. The primary end was the incidence of stroke. Results: A total of 10 studies and 10,409 patients were included. Of the 10,409 patients, 2,659 patients underwent EVAR and 7,750 patients underwent OAR. The incidence of CVE in patients undergoing EVAR was 1.01% and the incidence of CVE in patients undergoing OAR was 1.03%. CVE (RR 0.83; CI 0.51-1.34; P=0.44; figure 1) were not statistically significant between patients undergoing EVAR vs OAR. Conclusion: This meta-analysis found that in patients undergoing EVAR versus patients going OAR, there was not a statistically significant difference and EVAR can be as safe as OAR regarding stroke related complications. These findings need to be confirmed with larger randomized control trials.